Ivermectin, a pest used to treat river blindness, is prescribed outdoors with MMA to treat COVID-19 in some parts of the world, but regulators proposed randomized testing prior to widespread use.
On 3 April, researchers at Monash University in Australia demonstrated that ivermectin may inhibit SARS-CoV-2 in mobile crops, prompting a wave of enthusiasm for reusing the drug as an antiviral at a time when few opportunities were available, although the concentration of ivermectin used in vitro was well above the physiological degrees in clinical use in humans , the positive effects were disseminated and have since been cited in more than 450 publications.
Some doctors, bringing up this study, have already begun incorporating the non-compliant use of ivermectin into their COVID-19 remedy protocol, and in Peru and Bolivia, the ministries of fitness have officially legalized the drug for this indication. it is relatively safe, some scientists are involved in that doctors would possibly put the plow before the oxen prescribing ivermectin for COVID-19.
“The pandemic creates a sense of urgency and we have a tendency to cut some corners, and that would possibly be fine, but not every single corner is cut,” said Carlos Chaccour, MD, PhD, of the Barcelona Institute for Global Health in Spain, which studies ivermectin in the context of tropical diseases.
“Clinical rigor is needed. People can say, “What do you have to lose?It’s a drug, “but no drug loses any side effects,” he said.
Although the mechanism by which ivermectin acts as an antiviral is unknown, it has also inhibited viral replication with RNA viruses, adding dengue viruses and Zika viruses.
Ivermectin can cause gastrointestinal-looking effects or rashes and can be neurotoxic in rare circumstances. In an article published on May 1 through the FDA, the firm said that the use of the drug to save it or treat COVID-19 “should be avoided” in the absence of clinical trials.
The firm also issued a warning letter a week after the publication of the in vitro study, against the use of ivermectin veterinary formulas, presumably, the letter aimed to protect the public from misinformation, after a man died in March after eating. Chloroquine phosphate, an aquarium cleaner, when hydroxychloroquine (HCQ) made headlines.
In Peru, demand for the drug has been higher after approval, which has led some to veterinary formulas of the drug, which is used to treat the worm of the heart and can cause serious damage to humans.
“The FDA is involved in the fitness of consumers who would possibly self-medicate by taking ivermectin-based products for animals, thinking they can update ivermectin for humans,” the firm said. “People never take animal drugs because the FDA has only evaluated their protection and efficacy in the specific animal species for which they are labeled. “
However, in doses that are used outdoors with MMA for scabies, for example, ivermectin has a low profile of side effects. In the absence of many available opportunities, some doctors went to formal trials and began prescribing it for COVID-19.
Positive in Florida
Jean-Jacques Rajter, MD, lung care physician at Broward Health Medical Center in Fort Lauderdale, Florida, started with ivermectin to treat COVID-19 in critical patients after seeing the promising effects of the in vitro exam in April.
“At the time, dexamethasone, remdesivir and convalescence plasma were not on the market or inaccessible because few people had recovered,” Rajter told MedPage Today. “There was nothing else. “
Rajter said he had treated 15 to 20 patients in April with a popular dose of ivermectin against scabies and had a noticeably higher rate of good luck. Soon after, his Broward Health colleagues also began prescribing ivermectin, and Rajter and his wife and partner, Juliana Cepelowicz Rajter, MD, co-wrote a preprinted retrospective examination of 280 patients, published in June.
In the study, which was not peer reviewed, survival-related ivermectin gained advantages in patients with severe COVID-19 compared to the same previous care. The arrangement was maintained after the adjustment of the differences between the groups, adding the use of azithromycin, hydroxychloroquine and zinc, which is common.
“When this was published in the prepress, other researchers around the world saw it in Peru, Brazil, Colombia, Bangladesh, Mexico and Iraq,” Jean-Jacques Rajter said. “The good fortune we had in early April has been replicated in other studies around the world. “
Trials in Iraq, Bangladesh and Mexico have shown positive effects with ivermectin, but studies in Bangladesh and Mexico had no arm, and the Iraq test treated only 16 patients with ivermectin.
Matthew Spinelli, MD, of the University of California, San Francisco, told MedPage Today in an email that anecdotal reports are “difficult to interpret since patients with maximum inflammation will be older on their own and clinical manifestations are highly variable. . “
HcQ?
Parallels have been established with ivermectin and HCQ: either they have reduced the viral load in vitro and produced a sign that led to their prescription as compassionate use, said Zeno Bisoffi, MD, PhD, of the University of Verona in Italy.
“There were effects of observational studies that [hydroxychloroquine] worked, but in fact those were small studies with very giant methodological deficiencies,” Bisoffi told MedPage Today. evidence. “
“This is a mistake we need with ivermectin,” Bisoffi said.
Both drugs were also implicated in the infamous Surgisphere Corp scandal. At the end of May, misinformation about the phantom society used in a Lancet study since retracting to show that survival gained advantages with HCQ.
A lesser-known preprinted study of 169 international hospitals also used Surgisphere’s knowledge to demonstrate that ivermectin reduced the need for mechanical ventilation and death. but not before downloading more than 15,000 times.
The document influenced political decisions in Latin America and was cited in a white paper that advocated for the inclusion of ivermectin in Peruvian remedy guidelines.
The positive effects of the test in India are also being evaluated through the country’s medical review committee, Reported The Print. In Australia, a well-known drug-reusing gastroenterologist, Thomas Borody, MD, PhD, director of the Center for Digestive Diseases in Sydney, Australia, has approved ivermectin as a component of art, along with doxycycline and zinc, in an outpatient setting. Covid case19.
“Ivermectin has been used in billions of prescriptions to date, and even at maximum doses, there are very few side effects when used for things like scabies,” Borody told MedPage Today. “This combination of the 3 works so well that I think that’s the way to go. “
A for more research
While ICU doctors would possibly consider ivermectin to be a valuable thing to try, others think the evidence is still too scarce.
The drug does not deserve to be discarded, but it is also not in a widespread clinical condition, Chaccour said. For example, it is unclear whether it should be used in the context of a highly inflammatory syndrome, such as COVID-19. , or in mixture with other medications, he said.
Rajter said he had used ivermectin as a “measure of despair. “But now that you’ve noticed positive effects on your hospital system, you’re frustrated by a deliberately slow review process.
The FDA is accelerating some drugs, while “no other remedies have been introduced that have proven to be effective, such as ivermectin,” Rajter said.
Currently, there are more than 30 clinical trials with ivermectin for COVID-19. Bisoffi is reading the maximum doses of ivermectin for a benign infection and Chaccour is also conducting a trial in Spain. A Johns Hopkins University team compares ivermectin with biutamide and regimen treatment in PATIENTS hospitalized by COVID-19.
It remains to be seen whether ivermectin passes in a random controlled environment, however, scientists seem to agree that ivermectin at least justifies it.
“It is a pity that so few randomized controlled trials have been conducted in the United States on remedies like this,” Spinelli said.
Elizabeth Hlavinka covers clinical news and research articles for MedPage Today. It also produces episodes for the Anamnesis podcast.
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